新英格兰医学杂志：乙肝病毒感染药物治疗学

的指南中，HBV-DNA水平的单位为拷贝/ml。因为IU/ml与拷贝/ml的单位换算因子约为5.6（1IU/ml约为5.6拷贝/ml），以拷贝/ml为单位的治疗阈值是以IU/mI为单位的5倍。

N Engl J Med. 2008 Oct 2;359(14):1486-500.

Drug Therapy: Hepatitis B virus infection.

Dienstag JL.

Gastrointestinal Unit (Medical Services), Massachusetts General Hospital, and Department of Medicine and Office of the Dean for Medical Education, Harvard Medical School, Boston 02114, USA.

Reports of successful antiviral therapy for chronic hepatitis B virus (HBV) infection appeared three decades ago,1 and during the past decade, progress has accelerated dramatically. Along with progress, however, has come complexity. So much more is known now than at the dawn of the antiviral era about the protean clinical expressions of HBV infection that determining whom, when, and how to treat has become progressively more challenging.

Virologic and Epidemiologic Factors and Natural History

HBV, a DNA virus transmitted percutaneously, sexually, and perinatally, affects 1.25 million persons in the United States and 350 to 400 million persons worldwide. HBV infection accounts annually for 4000 to 5500 deaths in the United States and 1 million deaths worldwide from cirrhosis, liver failure, and hepatocellular carcinoma.2,3,4,5,6

Viral proteins of clinical importance include the envelope protein, hepatitis B surface antigen (HBsAg); a structural nucleocapsid core protein, hepatitis B core antigen (HBcAg); and a soluble nucleocapsid protein, hepatitis B e antigen (HBeAg). Serum HBsAg is a marker of HBV infection, and antibodies against HBsAg signify recovery. A serum marker of active viral replication, HBeAg, is accompanied by serum levels of HBV DNA that are 100,000 to 1 million IU per milliliter or higher. HBV relies on a retroviral replication strategy (reverse transcription from RNA to DNA),7 and eradication of HBV infection is rendered difficult because stable, long-enduring, covalently clo

上一页  [1] [2] [3] [4] [5] [6] [7] [8] [9] [10]  ... 下一页  >> 

对此文章有什么疑问,请提交在乙肝论坛